Organization
FENWAY HEALTH
Active
Parent organization
FENWAY COMMUNITY HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
FENWAY COMMUNITY HEALTH CENTER
Authorized official
MS. KARA ROBERTS (OFFICE ADMINISTRATOR)
(617) 927-6479
Entity
Organization
Contact information
Practice address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
(617) 927-6127
Mailing address
1340 BOYLSTON STREET, BOSTON, MA 02215
(617) 927-6127
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110020739B
—
MA
Enumeration date
07/27/2009
Last updated
07/27/2009
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